Minimally Invasive Transforaminal And Posterior Lumbar Interbody Fusion For The Treatment Of Lumbar Degenerative Diseases:A Meta-analysis

Objective:To systematically analyze the therapeutic effects of two approaches for lumbar fusion in the treatment of lumbar degenerative diseases.Methods:From the establishment of the database to December 2022,relevant documents in Pubmed,Cochrane Library,Web of Science,CNKI,China Biomedical Literature Database,Wanfang,and Vip databases were searched through computers.It is also supplemented by manual search of references to all retrieved research and review articles.Meta analysis is conducted after quality evaluation of the finally included literature.Results:A total of 11 articles were included in this study,with a total of 1054 patients.minimally invasive lumbar intervertebral fusion requires longer time compared to posterior lumbar intervertebral fusion [MD=26.48,95% CI(9.99,42.97),P<0.01],less intraoperative bleeding [MD=-180.85,95% CI(-228.45,-133.26),P<0.01],less postoperative drainage [MD=-90.67,95% CI(-232.50,51.16),P<0.01],and shorter postoperative hospital stay [MD=-2.78,95% CI(-4.56,-1.00),P<0.01],At 6 and 12 months after operation,the VAS score of postoperative low back pain was low and the pain symptoms were mild,[MD=-0.18,95% CI(-0.43,0.08),P=0.02],[MD=-0.11,95% CI(-0.30,0.08),P=0.02],and at 3 months after operation,the VAS score of postoperative leg pain was low and the pain symptoms were mild,[MD=-0.22,95% CI(-0.59,0.14),P=0.004],and the ODI score at 3 months after operation was low,[MD=-2.72,95% CI(-6.95,1.51),P<0.01],However,there was no statistically significant difference in the incidence of postoperative complications [RR=0.73,95% CI(0.40,1.36),P=0.15].Conclusion:Compared with posterior lumbar fusion,minimally invasive transforaminal lumbar fusion has the advantages of shorter postoperative hospital stay,less intraoperative bleeding,less postoperative drainage,less pain,rapid rehabilitation,and early postoperative landing,but the surgical time is longer.There was no significant difference in the incidence of postoperative complications between the two surgical approaches.